Visual Hallucinations in a Geriatric Psychiatry Clinic: Prevalence and Associated Diagnoses

Visual hallucinations are associated with a variety of psychiatric, medical, neurologic, and ophthalmologic disor-ders. One hundred forty outpatients presenting to a geriatric psychiatric clinic were screened for visual hallucinations and assessed on a number of descriptive variables, medical history, ophthalmologic history, psychiatric diagnosis, and cognitive score. The data revealed that 14 patients (10%) experienced visual hallucinations. Presence of visual hallucinations was significantly associated with diagnoses of dementia or delirium, living in a nursing home, lower cognitive score, and presence of auditory hallucinations and delusions. There was no association to number of med-ications, age, gender, or presence of eye disease. No patient had ’insight ’ into their visual hallucinations. Despite the numerous disorders that are associated with visual hallucinations, the most common causes in a geriatric psy-chiatry clinic are dementia and delirium. Clinicians assessing older patients with visual hallucinations should first carefully evaluate for these disorders. (J Geriatr Psychiatry Neurol 1996; 9:171-175). Visual hallucinations occur in a variety of psychiatric, neurologic, medical, and ophthalmologic disorders. Visual hallucinations have been associated with a variety of lesions at all levels of the visual systeml-5 including th